A pressure pain, frequently associated by an induration, is usually perceptible in the suprascapular region of the normal subjects. We considered the relation of the pressure pain with the anatomical structures of that region, firstly by investigating the locus of the pressure pain and whether it is associated by an induration or not, using the living subjects and in several cases, followed by a X-ray examination of the final destination of the needle which was inserted in the pressure pain zone; and lastly by dissecting the anatomical structures penetrated by that needle in a woman's cadaver.
We obtained the follwing three results from the above investigation and observations. (1) The most conspicuous pressure pain was perceptible in the middle of the upper margin of the suprascapular region, and a long and slender induration extending sagitally was palpable there. (2) The second rib lay in the deepest layer of the pressure pain zone, the layer which were overlain by the serratus posterior superior muscle, the serratus anterior and the omohyoid, many branches of the transversus colli artery and vein and the accessory nerve, and the trapezius muscle with the posterior suprascapular nerves running on its superficial surface, in order of lower to upper layer. (3) The transversus colli vessels, which forms a complex network of branchings crossing sagitally above the second rib, was suggested to have some relationship to the occurence of the pressure pain associated by the induration, because only the formation of such vascular network was peculiar to the pressure pain zone.

Introduction
We tried to prove the effectiveness of acupuncture against unidentified syndrome.
Method
Subjects were women complaining of unidentified syndrome and divided into the control group and test group. Galenicals extact was given to all of them and acupuncture was administered to the test group. The examination was a sequential medical trial in a restricted design (2α=0.05, 1-β=0.95, θ₁=0.90 and N=19). Acupuncture was applied twice a week for two weeks. We evaluated their subjective symptoms, difficulties in daily life and so on with MPI-test and MV-test.
Conclusion
Among the two groups, patients were randomly paired off into ten couples. Thus, a subjective comparison was possible. Global improvement rating by patients was effective for the symptoms of 60% of the test group, and 10% of the control group (p<0.05). As to the difficulties in daily life, it was effective for 70% of the test group, whereas only 20% of the control group. About subjective symptoms, there was a significant difference in the stiffness in shoulder (p<0.10). On MV-test, the test group of five pairs showed an increase in theta waves (p<0.05) and a decrease in beta waves (p<0.10).

The anatomical structures penetrated by a needle which was inserted in an acupuncture point into the stellate gaglion, 1.5cm lateral to and 2.5cm above the point Tentotsu, were studied bilaterally with dissection of 19 cadavers. Furthermore, the size of the dissected stellate ganglion, its anatomical position, and its positional relation to structures located near it were measured or observed.
Though 8 out of 38 inserted needles pricked the medial margin of the ganglion, the remaining 30 needles all missed medially from the ganglion. In the cases pricking the ganglion, all of 8 needles penetrated either the vertebral or the subclavian artery before reaching the ganglion, and 7 of these did also the dome of the pleura in addition to the artery. In the cases missing from the ganglion, however, a frequency of penetrating the above structures were considerably lower.
The dissected stellate ganglion almost lay on beteen the mid-level of the vertebral body of the 7th cervical vertebra and the upper level of body of the second thoracic vertebra, with their mean size 27.1, 7.7 and 2.8mm in length, width and thickness, respectively. All of the ganglions were located dorsal to the vertebral and subclavian arteries and the dom of the pleura the distances from the median line to their upper and lower extremity being 21.9 and 22.7mm in average, respectively.
The pricked point for directly aiming at the stellate ganglion from the body surface is within a range 20 to 30mm lateral to and 10 to 40mm above the point tentotsu on the right, and on the left it is within a range 15 to 25mm lateral and 10 to 35mm above; the depth from the point is about 4.0 and 3.8cm on the right and left, respectively. But when directly aiming at the ganglion, the possibility of injuring the vertebral or subclavian artery and the dome of the pleura was suggested to increase considerably owing to their location ventral to the ganglion.

The positional relation of the superior cervical ganglion with different anatomical structures were investigated, using cadavers, in order to devise the methods of acupuncture to the superior cervical ganglion. Furthermore, the anatomical structures penetrated by a needle which was inserted with the methods of acupuncture thus devised were investigated using another group of cadavers. The results obtained are as follows.
1) The superior cervical ganglion was located just above the bifurcation of the common carotid artery and medial to the angle of the mandible. The height of location of the ganglion was 30mm below the mastoid process, 21mm below the transverse process of the atlas, and 40mm above the lateral edge of the body of the hyoid bone.
2) From the above positional relation, we devised the method of acupuncture in which a needle was horizontally inserted from the lateral surface of the neck to the front of the transverse process of the cervical vertebra at the height 30mm below the mastoid process. We named this method the lateral acupuncture.
3) When considering on the basis of the lateral edge of the body of the hyoid bone, the superior cervical ganglion was located at the angles 15° lateral and 45° above.
4) From the above angles, we devised the method of acupuncture in which a needle was inserted from the lateral edge of the body of the hyoid bone at the angles of 45° above and 15° lateral. We named this method the anterior acupuncture.
5) The inserted needle of the lateral acupuncture reached the superior cervical ganglion at high frequency, it, however, had high possibility of penetrating the external and internal carotid arteries and the internal jugular vein.
6) The inserted needle of the anterior acupuncture reached the ganglion at slightly lower frequency, it, however, had lower possibility of penetrating the large vessels.

The incidences of the middle cervical and the vertebral ganglia and their sizes were investigated bilaterally during dissection of 18 cadavers. Furthermore, the positional relations of each ganglion to the vertebral column, the point Tentotsu, the anterior tubercle of the sixth cervical (C₆) vertebra, and the cricoid cartilage were investigated along with the relations of the anterior tubercle of the C₆ vertebra to the point Tentotsu and the cricoid cartilage. The middle cervical ganglion was 14, 4 and 2mm in average length, width and thickness, respectively, on the right, and on the left these values were 14, 5 and 2mm. The ganglion was found in about half the cases, and it was located at about the level of the cricoid cartilage and close laterally and above to the anterior tubercle of the C₆ vertebra. In the cases lacking the middle cervical ganglion, the sympathetic trunk passed immediately medial to the tubercle. The vertebral ganglion was found in almost all cases, with its mean size 8, 5 and 3mm on the right and 9, 5 and 2mm on the left in lenght, width and thickness, respectively. The ganglion was included in many cases within a range 15 to 30mm lateral and 20 (the left) or 25 (the right) to 45mm above the point Tentotsu, and it lay at the level of the C₇ vertebra. The anterior tubercle of the C₆ vertebra was within a range 20 to 30mm lateral to that point, and in the upper to lower direction, it lay at the level slightly upper than the cricoid cartilage in the male and at about the level of the cartilage in the female.

Aim : Since it was reported that acupuncture at Danchu (CV17) was critical when the needle penetrated through the congenital sternal foramen, we decided to study the incidence of the congenital sternal foramen, as well as the distance between the body surface and the back side of the sternum at Danchu, in order to know the safe depth of acupuncture penetration.
Method : 1) We selected 51 cadavers to examine the incidence of congenital sternal foramen and, if any, to study its structure. We also selected 21 cadavers to measure the cadaveric thickness of the sternum. 2) We selected 31 people to measure the incidence of the congenital sternal foramen and the distancebetween the body surface and the back side of the sternum at the point of Danchu.
Results : 1) We found one out of 51 cadavers which had congenital sternal foramen. The location of the foramen was at the height of the fourth intercostal space. It was round-shaped, 9mm in diameter, and filled with hard connective tissue. The thickness of the sternum ranged from 9 to 15mm with an average of 11.5 ± 2mm. 2) There was no one who had the congenital sternal foramen among the 32 people. The distance between the body surface and the back side of the sternum ranged from 11 to 31mm with an average of 18.8 ± 5mm.
Conclusion; 1) The incidence of the congenital sternal foramen in this study was one in 51 cadavers and zero in 32 people. 2) We concluded that acupuncture at Danchu within a depth of 10mm is sufficiently, even if congenital sternal foramen exists.

Acupuncture to Gaohuang carries a risk of causing pneumothorax because it reaches the lungs at deep portion. This study was designed to consider a safe depth for acupuncture to Gaohuang.
1) We inserted a needle to Gaohuang on both sides of a cadaver to examine the location of the needle tip and measure the distance from the body surface of the left Gaohuang to the pleura. The tip was located at the fifth intercostal region on both sides, and the distance was 44 mm with a rib thickness of 10 mm. 2) Using 104 students, we inserted a needle to the left Gaohuang until the tip reached the rib, and measured the distance between the bodysurface and rib. The minimal distance was 14 mm. 3) We inserted a needle to Gaohuang on both sides of two males and took CT-radiographs to examine the location of the needle tip and measure the distance from the body surface of Gaohuang to the pleura. In a man of standard body size, the needle reached the rib on the left and the intercostal region on the right. The thickness of the left rib was 10.9 mm, and the distance from body surface to pleura was 33.6 mm on the left and 28.4 mm on the right. In a man of thin body size, the needle reached the rib on both sides, with the rib thickness was 9.8 mm on the left and 8.8 mm on the right. The distance from body surface to pleura was 29.4 mm on the left and 31.8 mm on the right. The above results showed that needle insertion within 19 mm (the minimal value of the measured distance between the body surface and rib + the half thickness of the rib) is safe.

The projection region of the dome of the pleura to the surface of the anterior neck was investigated in 31 domes of 17 cadavers. The point “Tentotsu”, and a line connecting that point and the most lateral edge of the acromion were adopted for a basis of measurement of the projection region. The mean length of the Tentotsu-Acromion line was 185mm on either side of the body. Its upward angle to the horizontal plane was 22° and 23° in average on the right and left sides, respectively, while its backward angle to the frontal plane was 23° on the right and 25° on the left. The right pleural domes (17 cases) were included within a range 0-58mm lateral to the Tentotsu and lower than 44mm above, and on the left side (14 cases), these values were 5-58mm and 49mm, respectively. On the other hand, when adopting the Tentotsu-Acromion line as the basis, the pleural domes were located within the medial one-third of the line. Their summits lay on the point of its medial one-fourth in medio-lateral direction, and were situated at levels lower than about 35 (on the right) or 32mm (on the left) above the line.

Twenty-six domes of the pleura of thirteen cadavers were investigated. The summits of all domes protruded above the clavicle. Mediolateral positions of the summits were located between the lateral edge of the origin of the sternal head of the sternocleidomastoid muscle (CL3) and the lateral edge of the origin of its clavicular head (CL5), and their craniocaudal positions were located between the Point “Suitotsu” (S₁₀) and the medial edge of the origin of the clavicular head (CL4). The lateral edges of the domes did not reach the level of the clavicle. Their mediolateral positions were located between CL4 and the Point “Ketsubon” (S₁₂), and their craniocaudal positions were located between CL5 and the sternal extremity of the clavicle (CL2). The medial edges of the domes were both mediolaterally and craniocaudally located between CL2 and the suprasternal point. Projection regions of the domes of the pleura to the surface of the anterior neck were included, in all cases, within the quadrate region connecting the following four points: the Point “Suitotsu” (S₁₀), a point of intersection between the median line and a line drawn vertically from the Point “Suitotsu” (S₁₀) toward the median line, the suprasternal point, and a point on the clavicle corresponding to the medial one-third of the half shoulder width.